Kaiser, HMSA hike insurance premiums

  • YADAO

Most health insurance policyholders began paying higher premiums this week. The increases range from 5.9 percent to nearly 25 percent.

“There are several factors that contribute to premium adjustments each year, including rising prescription drug and health care costs, and fees associated with the Affordable Care Act,” said Elisa Yadao, senior vice president for Hawaii Medical Service Association, a nonprofit that is one of Hawaii’s largest insurers.

William Nhieu, spokesman for the Hawaii Insurance Commissioner’s Office, said reasons for premium increases also include “increased utilization of services, expensive technologies and procedures, unhealthy behavior and lifestyle choices, the aging population and high end-of-life costs.”

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He said the average Kaiser Permanente small-group premium will increase about 5.9 percent on average, the large-group plan will go up 6.4 percent and Affordable Care Act rates for individuals will rise 24.1 percent.

Average HMSA premiums, Nhieu said, will increase by about 11.2 percent on average for large-group insurance, 9.3 percent for small group and 19.8 percent for the Affordable Care Act.

Insurance Commissioner Gordon Ito was quoted by the Honolulu Star-Advertiser last week as saying, “these rate increases (both Kaiser and HMSA) illustrate the need to bend the health care cost curve,” noting premiums have been doubling every 10 years.

Laura Lott, spokeswoman for Kaiser, the state’s other large nonprofit health insurance provider, said consumers can help control such costs.

“A healthy lifestyle is the best gift you can give yourself. Good nutrition and exercise make all the difference,” she said.

Kaiser’s “FitRewards” program is an example, she said. It gives policyholders a free gym membership if they work out at least 45 days a year.

Nhieu said consumers should look at more than premiums to see if they’re getting a good deal. For example, they should review the policy’s coverage, deductibles and maximum out-of-pocket per year.

Only about 3.5 percent of Hawaii residents do not have health insurance at all, Nhieu said.

“Hawaii consistently ranks as a state with one of the lowest uninsured rates in the nation,” he said. A larger pool of insurance participants “in theory” would help stabilize premium rates, he added.

Even those who already have health insurance can cut costs, Yadao said.

“In addition to choosing to lead a healthy lifestyle, exercising regularly and developing a relationship with your doctors, there are many things we can do to reduce costs,” she said.

She told a story of a parent who recently bought a medication for a daughter’s ear infection. The price was $100. The doctor later told the parent that had a phone call been made to the physician’s office, the practitioner could have instead prescribed a cheaper medicine.

Yadao said if you’re confronted with such a price, ask questions and see if there’s a cheaper medicine available.

Health care is a big cost for employers, too. They can make a difference for employee satisfaction by starting programs to help workers stay healthier — which has the side benefit of lower health care costs.

“Every year, we see more companies engaging their employees in well-being programs in the workplace,” Yadao said. “These programs get employees active and mindful of their health and can improve social connections and lead to higher productivity and happier, more satisfied employees.”

Hawaii is different from states on the mainland that don’t require employer-based insurance.

“We’re fortunate here in Hawaii that we have elected officials and regulators who make health a priority and are working with HMSA and other stakeholders to address the rising cost of health care,” Yadao said. “Some examples include passing laws to improve the availability of telehealth and increasing health care services in rural communities. There’s also a strong local government push to improve well-being programs to decrease childhood obesity rates by increasing physical activity and promoting local agriculture in our schools and beyond.”

Lott, of Kaiser Permanente, said she would recommend employers “invest in workplace wellness programs, make healthy food choices available in the work place and walking paths, walking programs, etc.”

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Policymakers, she said, should support “walkable” communities, healthy school lunches and limited access to sugary drinks.

Email Jeff Hansel at jhansel@hawaiitribune-herald.com.